When is a Sore Throat Not Just a Sore Throat?


Woman sitting on couch clutching her sore throat while drinking herbal honey and lemon tea

A sore throat is one of those symptoms that probably reminds you of your childhood. In those days, your sore throat remedies were simple: staying home from school (watching The Price is Right) and having chicken noodle soup. Or maybe you nursed your sore throat with cough drops and your favorite Netflix show.

Whatever the case, your sore throat was a kind of routine childhood illness. And that’s the way you still think about this symptom: routine. When you get a sore throat, you wait a few days and expect to be as good as new.

But what if your sore throat is, well, not just a sore throat? There are some instances in which a sore throat can indicate a more serious illness. But how do you know when that might be?

Common sore throat causes

Unfortunately, a sore throat is not a particularly unique symptom of illness. In part, that’s because of the way your body tends to fight off infections (lots of mucus leading to lots of irritation). As a result, many of the following viral sore throat causes are relatively common:

  • The Common Cold: As you’re probably aware, the common cold can often result in a runny or stuffy nose. Post-nasal drip can trickle down the throat, causing irritation and soreness.
  • Influenza: The flu can cause a wide variety of symptoms, including sore throat. Other symptoms may include aching joints and high fever.
  • Chicken Pox: While most commonly associated with the mosquito-bite-like bumps that appear (and itch), chicken pox can also cause several other symptoms, including a sore throat.
  • Croup: This is an infection of the upper respiratory tract, and it’s very common in children. In addition to the sore throat, those with Croup will develop a unique “barking” cough.
  • Mononucleosis (often simply called “mono”): Sometimes called “the kissing disease,” mono is spread via saliva and typically results in extreme fatigue.
  • COVID-19: The novel coronavirus has been known to cause sore throats in some people who develop symptoms. This is more common (and typically more severe) in both Delta and Omicron variants of COVID-19.

Antibiotics will have no impact on viral illnesses. So your doctor will usually just tell you to rest up and let your body heal! For symptom relief, you can rely on sore throat remedies like cough drops and fluids.

This will vary by the virus. Sometimes therapeutic treatments are available (for example, steroids or specially designed antivirals). Seek treatment if any of these viral symptoms linger.

Common, non-viral causes of sore throats

In some cases, it’s not a virus but a bacteria that causes your sore throat symptoms. This is the case with Strep Throat, which is an incredibly common bacterial illness. Usually, antibiotics are prescribed for strep throat, and these therapeutics will clear up your sore throat symptoms in a matter of days.

There are even some common causes that have nothing to do with bacteria or viruses. These include:

  • Allergies or allergic reactions.
  • Irritation from pollutants and chemicals.
  • Acid reflux or heartburn.
  • Irritation from weather (for example, high heat or frigid cold), especially in very low humidity.

Can a sore throat be a serious symptom?

In most cases, sore throat causes will be something common, like a cold or flu. But a sore throat can also be a sign of some less common–but often very serious–illnesses. Some of those serious conditions include the following:

  • Chronic tonsillitis: Sometimes your tonsils become a site of repeated infections. When these infections occur too often, the tonsils must be removed. Both tonsillitis and the surgery to remove your tonsils can cause a severe sore throat.
  • Thyroid issues: Your thyroid typically dispenses certain hormones throughout your body. Your thyroid is located in your neck, so when it stops working correctly or becomes swollen for any reason, this can result in sore throat symptoms.
  • Cancer: In some cases, a sore throat can be caused by one of several different types of cancers. Treatments could involve a combination of surgery, radiation, and chemotherapy.
  • Tumors: Sometimes it’s the tumor itself that can cause your sore throat. As the tumor grows, it can put pressure on parts of your throat or cause other inflammation. This is especially true for tumors located in the throat, tongue, or larynx.
  • HIV infections: Your lymph nodes are a critical part of your immune system. When you have HIV, these lymph nodes fill with fluid—and this fluid can cause the sore throat symptom.
  • Epiglottitis: This potentially fatal swelling of the epiglottis needs to be treated right away. It is usually caused by an infection of Hib (haemophilus influenzae type B), but can sometimes be the result of trauma.

How do I know if my sore throat is common… or serious?

So, you have a sore throat and none of your usual sore throat remedies seem to work. Understandably, you want to know if you should be worried. The good news is that in almost all cases, a sore throat will be gone in just a few days.

However, there are some signs that you may have a more serious condition:

  • Trouble breathing: If your sore throat is interfering with your ability to breathe, you should contact a medical professional immediately.
  • You have a high fever: If you have a fever, and you can’t keep your temp down with over-the-counter medications such as Tylenol, contact your doctor.
  • Your sore throat isn’t going away: If your sore throat lingers for more than 3-5 days, that could be a sign that something more serious is going on (even if that something more serious is a particularly severe case of strep throat). If your sore throat isn’t going away, be sure to see your doctor as soon as you can.
  • Take an at-home Covid test: It won’t hurt to rule out COVID-19 as a potential cause of your sore throat. This can also help prevent you from infecting others with Covid.

There are some other signs that something serious may be going on. If, for example, you notice any sores or lumps, be sure to make an appointment with your doctor. In fact, your doctor is really the only one who can tell you for sure whether something’s happening or not.

So the basic rule of thumb is this: a sore throat is pretty normal and will usually go away on its own. But if any symptoms linger for longer than two weeks, it’s a good idea to make an appointment with your doctor. (Just make sure to rest up and binge your favorite Netflix show in the meantime.)

Find a provider in your area to schedule an appointment by searching providers near you.

Want more information?

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